Concept of NIKSHAY Episode, Case in the care cascade

Concept of NIKSHAY Episode, Case in the care cascade

A person may get affected with TB more than once in his lifetime. There is a chance that the person may get re-infected with TB or there may be a change in the type of TB Disease (New to Recurrent or DRTB).

In Ni-kshay there is a lifecycle approach. A patient/ person are tracked in Ni-kshay across different episodes. When a presumptive TB is entered in Ni-Kshay Universe for the first time, a unique id is generated as Patient ID. For the first episode in life cycle the Patient ID and Episode ID are same (Numerically Equal). For every Episode we need to take patient to the logical end and declare the outcome of existing Episode.Once the outcome is declared for previous Episode then only new episode can be created. Therefore a person who get affected with TB more than once in his lifetime then there is one Patient Id and multiple Episode IDs for the same patient. You may do global searched by both Episode ID and Patient ID for any case.

Examples:

1. Mr. Ramesh got diagnosed as a case of TB in January 2018 as a new case and later got cured; later in March 2019 he got diagnosed with TB again as a case of recurrent TB. The recurrent TB is the second TB episode of Ramesh.

2. Mr. Suresh was diagnosed on microscopy on 1 April 2022 with Gene Xpert on 2 April 2022 Rif Resistance not detected was put on first line treatment. His indirect LPA report came on 20 May 2022 as Rif Sensitive, INH resistant. We need to Close existing episode with outcome as treatment regimen changed and open the new episode of H mono /Poly Regimen.

3. Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.

Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.

Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.

Example

Mr. Ramesh got diagnosed as a case of TB in January 2018 as a new case and later got cured; later in March 2019 he got diagnosed with TB again as a case of recurrent TB. The recurrent TB is the second TB episode of Ramesh.

Mr. Suresh was diagnosed on microscopy on 1 April 2022 with Gene Xpert on 2 April 2022 Rif Resistance not detected was put on first line treatment. His indirect LPA report came on 20 May as Rif Sensitive, INH resistant. We need to Close existing episode with outcome as treatment regimen changed and open the new episode of H mono /Poly Regimen.

Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.

Example

Mr. Ramesh got diagnosed as a case of TB in January 2018 as a new case and later got cured; later in March 2019 he got diagnosed with TB again as a case of recurrent TB. The recurrent TB is the second TB episode of Ramesh.

Mr. Suresh was diagnosed on microscopy on 1 April 2022 with Gene Xpert on 2 April 2022 Rif Resistance not detected was put on first line treatment. His indirect LPA report came on 20 May as Rif Sensitive, INH resistant. We need to Close existing episode with outcome as treatment regimen changed and open the new episode of H mono /Poly Regimen.

Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.

Example

Mr. Ramesh got diagnosed as a case of TB in January 2018 as a new case and later got cured; later in March 2019 he got diagnosed with TB again as a case of recurrent TB. The recurrent TB is the second TB episode of Ramesh.

Mr. Suresh was diagnosed on microscopy on 1 April 2022 with Gene Xpert on 2 April 2022 Rif Resistance not detected was put on first line treatment. His indirect LPA report came on 20 May as Rif Sensitive, INH resistant. We need to Close existing episode with outcome as treatment regimen changed and open the new episode of H mono /Poly Regimen.

Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.

Example

Mr. Ramesh got diagnosed as a case of TB in January 2018 as a new case and later got cured; later in March 2019 he got diagnosed with TB again as a case of recurrent TB. The recurrent TB is the second TB episode of Ramesh.

Mr. Suresh was diagnosed on microscopy on 1 April 2022 with Gene Xpert on 2 April 2022 Rif Resistance not detected was put on first line treatment. His indirect LPA report came on 20 May as Rif Sensitive, INH resistant. We need to Close existing episode with outcome as treatment regimen changed and open the new episode of H mono /Poly Regimen.

Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.

Example

Mr. Ramesh got diagnosed as a case of TB in January 2018 as a new case and later got cured; later in March 2019 he got diagnosed with TB again as a case of recurrent TB. The recurrent TB is the second TB episode of Ramesh.

Mr. Suresh was diagnosed on microscopy on 1 April 2022 with Gene Xpert on 2 April 2022 Rif Resistance not detected was put on first line treatment. His indirect LPA report came on 20 May as Rif Sensitive, INH resistant. We need to Close existing episode with outcome as treatment regimen changed and open the new episode of H mono /Poly Regimen.

Mr. Ganesh who was put on Shorter MDR regimen, on the basis of Exclusion criteria and Gene Xpert and LPA Report, while on treatment after 8 months, come follow up positive with additional resistance to FQ, then existing episode is given outcome as Treatment Failure, and a new episode for All Oral regimen is created.